# What is the 421 rule?

In anesthetic practice, this formula has been further simplified, with the hourly requirement referred to as the “4-2-1 rule” (4 mL/kg/hr for the first 10 kg of weight, 2 mL/kg/hr for the next 10 kg, and 1 mL/kg/hr for each kilogram thereafter.

## How do I calculate my child's daily maintenance fluid requirement?

1. For infants 3.5 to 10 kg the daily fluid requirement is 100 mL/kg.
2. For children 11-20 kg the daily fluid requirement is 1000 mL + 50 mL/kg for every kg over 10.
3. For children >20 kg the daily fluid requirement is 1500 mL + 20 mL/kg for every kg over 20, up to a maximum of 2400 mL daily.

## How do you calculate daily fluid requirements?

Formulas Used:
1. For 0 - 10 kg = weight (kg) x 100 mL/kg/day.
2. For 10-20 kg = 1000 mL + [weight (kg) x 50 ml/kg/day]
3. For > 20 kg = 1500 mL + [weight (kg) x 20 ml/kg/day]

## How do you calculate pediatric fluid bolus?

This is determined by multiplying the percentage dehydration times the patient's weight (e.g. 10% dehydration in a 10 kg child: 10% of 10 Kg = 1 kg = 1 liter). Subtract any boluses from this volume (e.g. 1 liter – 400 ml of boluses = 600 ml).

## How do you calculate pediatric IV fluids?

24-hour fluid requirement
1. Fluid deficit = 10% x 15kg x 10 = 1500 mL.
2. Maintenance fluids = 1000 mL (first 10 kg) + 250 mL (last 5 kg) = 1250 mL.
3. Total fluid requirement = 1500 + 1250 = 2750 mL/day » 115 mL/hour.

## How is pediatric fluid deficit calculated?

Deficit (mL) = weight (kg) x % dehydration x 10
1. For children with ≤5% dehydration, replace deficit in the first 24 hours.
2. For children with >5% dehydration, replace deficit more slowly.

## How do you calculate IV fluid rate?

Drip Rates — is when the infusion volume is calculated into drops. The formula for the Drip Rate: Drip Rate = Volume (mL) Time (h) . A patient is ordered to receive 1 000 mL of intravenous fluids to run over 8 hours.

## What is the formula of fluid calculation?

The formula for calculating the IV flow rate (drip rate) is total volume (in mL) divided by time (in min), multiplied by the drop factor (in gtts/mL), which equals the IV flow rate in gtts/min.

## How is fluid target calculated for elderly?

A formula used to calculate fluid requirements for older people is: U 100 mL fluid per kg body weight for the first 10 kg U 50 mL fluid per kg for the next 10 kg U 15 mL fluid per kg for each kg after 20 kg.

## How do you calculate 24 hour fluid maintenance?

The 24-hour number is often divided into approximate hourly rates for convenience, leading to the "4-2-1" formula.
1. 100 ml/kg/24-hours = 4 ml/kg/hr for the 1st 10 kg.
2. 50 ml/kg/24-hours = 2 ml/kg/hr for the 2nd 10 kg.
3. 20 ml/kg/24-hours = 1 ml/kg/hr for the remainder.

## How much water should a 60 lb child drink?

Subtract 44 from your child's weight in pounds for children weighing more than 44 pounds. Multiply your result by 0.3. Now add 51 to get the minimum ounces of fluid needed per day. For example, a 50-pound child needs at least 53 ounces of fluid daily.

## How do I calculate flow rate?

If you can see the fluid flowing, you can measure its velocity, and that means all you need is the area through which the fluid is flowing to calculate the flow rate using the formula ​Q​ = ​A​ × ​v​.

## What is a normal IV saline rate?

A common initial rate is 30 mL/hour IV continuous infusion, with further rate adjustments based on close monitoring of ICP, serum sodium, serum osmolarity, neurologic, hemodynamic, and renal status.

## How fast do you give a fluid bolus?

A volume of 250 ml defines a fluid bolus, with a range from 100 ml to >1000 ml, and speed of delivery from stat to 60 minutes. Most nurses expect substantial physiological effects with FBT.

## How much IV fluid should be given for dehydration?

If hydration is not improving, give fluids more rapidly; the patient may need 200 ml/kg or more of intravenous fluids during the first 24 hours of treatment. You can decrease the amount of fluid if the patient becomes hydrated earlier than expected.

## How do you calculate dehydration?

After clinical signs have been observed, the degree (%) of dehydration should be determined. This is calculated by dividing the difference between the pre-illness and illness weights by the pre-illness weight, then multiplying by 100 (Table 5). For example, a 10-kg patient who has lost 1 kg is 10% dehydrated.

## How do you calculate doses?

D/H x Q = x, or Desired dose (amount) = ordered Dose amount/amount on Hand x Quantity.
...
Dimensional Analysis Method
1. The clinician has 2 mg/mL vials in the automated dispensing unit.
2. How many milliliters are needed to arrive at an ordered dose?

## What is Dillings formula?

An age-based formula for calculating the paediatric dose of a drug: (child's age in years/20) x adult dose.

## Do you round pediatric doses?

Pediatrics – use the same rounding rules applied to adult medications depending on type. Kilograms – round to the nearest tenth. Body Surface Area – round to the nearest hundredth.
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